Article

A rehabilitation program including foot sensory stimulation, balance and gait
training with limited vision was followed by 30 patients with ataxic neuropathy
in order to stimulate multi-sensory compensation in a no-controlled and
no-blinded study. Ataxic neuropathy was graded by a pallesthetic score. The
evaluation of patients and healthy subjects was performed with clinical tests
(Berg Balance Scale, Functional Reach Test and Timed up and Go test) and
instrumental tests for balance (force platform) and gait (Locometre). All
patients exhibited impairments in balance and gait parameters compared to control
group values. A high pallesthetic score correlated with increased sway area when
standing with the eyes open on a firm surface. At the end of the training
program, significant changes were observed in balance control assessed using the
three clinical tests (Wilcoxon test, p<0.001). A tendency towards a reduction of
the Romberg sign was noticed and limited changes were observed after training in
instrumental tests for balance and for gait parameters. Age induced some
limitations in balance and gait parameters but had no effect on training results.
These results show that ataxic patients are impaired in balance and gait but can
improve clinical balance parameters following training with a multisensory
approach without limitation due to age or degree of sensory impairment. Only
limited correlations were noticed between the pallesthetic score and some balance
parameters, suggesting that various levels of compensation occur in these
patients. The effectiveness of this training program has to be evaluated in the
future in a controlled study to ascertain the contribution of the placebo effect
in these data.
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